Healthcare Provider Details

I. General information

NPI: 1962472829
Provider Name (Legal Business Name): SAM NMI SAREH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 CORAL HILLS DR STE 240250
CORAL SPRINGS FL
33065-4146
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-884-0111
  • Fax: 954-366-6120
Mailing address:
  • Phone: 954-884-0111
  • Fax: 954-366-6120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME91255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: